This entry describes treatment and recovery issues for those who identify as lesbian, gay, bisexual, transgender and/or queer (LGBTQ) and struggle with substance abuse. It begins by reviewing the prevalence of substance abuse among LGBTQ communities with a focus on the variable risks that may lead LGBTQ people to abuse substances and the consequences they experience as a result of engaging in substance abuse. The entry then reviews issues related to the treatment of substance abuse among LGBTQ communities, including barriers to treatment and the need for LGBTQ specific and affirming models of care. The entry concludes with a discussion of issues and challenges related to recovery for LGBTQ people who abuse substances.